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Engorgement is unfortunately a common experience
Breasts feeling overly full from either too much milk or too much bodily fluid (or both). It’s most common in the first few days after birth, but it can also happen later in your lactation journey if your milk is backed up for any reason (ineffective latch or pumping, long period of time between feeding/pumping, clogged duct, etc). Plugged ducts and Mastitis are related to engorgment so I’ve devoted a stand-alone blog post for more info.
Engorgement is exacerbated by:
IV fluids during labor (if your ankles are swollen after birth, your breasts can be too!)
Breastfeeding or pumping challenges, OR scheduled feedings/pumping that have longer intervals than your breasts can comfortably hold - lead to removing less milk from the breast, and causing the milk to get “stuck”. This can lead to pain, inflammation and possibly plugged ducts/mastitis. See my pages devoted to latch, position, pumping, and much more.
Engorgement is aided by:
Anything that clears the path for milk to move out of the breast, or bodily fluid to go back to the body! Breast massage, reverse pressure softening, cool compresses, cabbage leaves, anti-inflammatory measures, and more!
Therapeutic Breast Massage (this video also has hand expression - more on that below)
Great instagram post showing ideas for therapeutic breast massage including some lymphatic drainage - quick and easy to watch!
“Breast Gymnastics” (and here’s a 2nd Breast Gymnastics post too!).
Reverse Pressure Softening - softens the areola to help a baby latch, or for pump flanges to fit better.
For professional therapeutic breast massage - in NJ I highly recommend Rena' Ambrose of Mend Lymphatic Massage and Wellness Services. If you are in another area, check with your local IBCLC!
Effective pumping (including correct flange sizing which is almost definitely smaller than you think!)
And - for sure - Hand Expression!
Hand Expression
Literally the most “handy” skill to know
Relieves engorgement or plugged ducts
Express/collect colostrum - which is sticky and tends to get stuck on pump parts! Hand express directly into a spoon or small cup and you will have enough to fill your newborn’s tiny tummy for a feeding! Antenatal hand expression is also very useful to collect colostrum before the baby is born.
For getting milk in general - it can be a great add-on to pumping, and also very helpful if you lose power or are without your pump. With practice some people are able to get as much milk from hand expression as from a pump!
Here are a variety of resources for hand expression
What’s interesting is how different they are and yet all effective. In the end, this tells me that you have to “play with your boobies” to figure out which works best for you!
Therapeutic Breast Massage and Hand Expression video by Maya Bolman (also listed above under breast massage)
Hand Expression - Stanford Medical Center, Jane Morton. Also by Jane Morton, the website Droplet’s ABCs page has great videos for hand expression (and the rest of the site has wonderful info as well).
Hand Expression Video by Global Health Media.